Differences in the characteristics of people who purchase pesticides from shops for self-harm versus those who use pesticides available in the domestic environment in Sri Lanka
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Data from South Asia indicate that for 15%–20% of suicide attempts, pesticides are purchased from shops; otherwise, pesticides are obtained from an individual's house or nearby environment. We aimed to investigate the difference between individuals who directly purchase pesticides from shops for suicide attempts and suicide deaths versus those related to accessing the pesticides from an individual's house or nearby environment.
We conducted two comparative studies in rural Sri Lanka: (1) non-fatal shop cases (n = 50) were survivors of self-poisoning with pesticides who ingested the pesticides after purchasing them from a shop; non-fatal domestic cases (n = 192) were survivors who accessed pesticides from their house or nearby environment. (2) fatal shop cases (n = 50) were individuals who died after ingesting pesticides they purchased for the act; fatal domestic cases (n = 102) were patients who died after ingesting pesticides they accessed at house or nearby environment. Logistic regression analysis was used to assess the characteristics which distinguished between the shop and domestic cases.
Data indicate that 20.7% and 32.9% of individuals who used pesticides for suicide attempts and suicide deaths had purchased them from shops, respectively. Being a non-farmer was the main distinguishing characteristic of shop cases: adjusted odds ratios (AOR) 8.9, 95% confidence intervals (CI) 3.2–24.4 for non-fatal shop cases, and AOR 4.0, 95% CI 1.5–10.6 for fatal shop cases. Non-fatal shop cases also had higher suicide intent (AOR 3.0, CI 1.0–8.9), and ingesting an insecticide (AOR 4.8, CI 1.8–1.0–8.9) than non-fatal domestic cases.
A high suicide intent of individuals who purchase pesticides for the event explains the high proportion of such fatal cases. Such high suicide intent makes the prevention implications difficult to spell out for those individuals who purchase pesticides for self-poisoning. However, our findings are valuable for clinicians to assess pesticide poisoning cases in hospitals.
|Tropical Medicine and International Health
|Udgivet - 2023
We acknowledge all the field researchers who undertook the data collection (Kalpani Dissanayaka, Tharidu Jayathilaka, Chathurani Pabasara, Sandamali Rajapaksha and Prasanna Thilakarathna). David Gunnell and Keith Hawton are both National Institute for Health Research (England) Senior Investigators. Michael Eddleston was a Lister Research Prize Fellow. KH is joint chair of the Prevention of Pesticide Self‐Poisoning Special Interest Group of the International Association for Suicide Prevention. He declares having received a small grant from Syngenta for a study of safer storage of pesticides in Sri Lanka. DJG, FK and ME were expert advisers to WHO’s consultation on the cost‐effectiveness of suicide prevention interventions, including pesticide regulation (Geneva, 2019). They provided technical assistance for the development and publication of Preventing Suicide: A Resource Guide for Pesticide Registrars and Regulators (WHO, May–June 2019). DJG was a member of the scientific advisory group for a Syngenta‐funded study to assess the toxicity of a new paraquat formulation (2002–2006); a member of the scientific advisory group for a pesticide storage project funded by Syngenta (2005–2007); and chaired the DMEC for a Syngenta‐funded trial of the medical management of paraquat poisoning (2007–2010); he received travel costs to attend research meetings but no other fees. DJG was an expert adviser to WHO’s First Consultation on Best Practices on Community Action for safer access to pesticides (Geneva, 2006). ME is a WHO member of the FAO‐WHO Joint Meeting on Pesticide Management and received an unrestricted research grant from Cheminova (2012) and travel expenses from Syngenta to attend study meetings (2005–2006). The Centre for Pesticide Suicide Prevention is funded by a grant from Open Philanthropy, at the recommendation of GiveWell.
© 2023 John Wiley & Sons Ltd.